Clinical course of AD and ACD overlap syndrome accompanied by chronic fatigue

Background. Studies have revealed a positive correlation between atopic dermatitis (AD), allergic contact dermatitis (ACD) and chronic fatigue syndrome (CFS). It is well known that CFS is accompanied by immunological disorders, the correction of which is carried out with the use of antioxidants and vitamin D, as well as various immunomodulatory agents of natural origin, in particular probiotics. The purpose was to study the effect of a natural probiotic complex containing Bacillus spp. on the clinical course of CFS in patients with overlap syndrome (OS) of AD and ACD. Materials and methods. Patients in the study group (n = 30), in addition to the basic therapy for OS of AD and ACD, were recommended to take resveratrol (250 mg 1 time per day), vitamin D (4000 IU once daily), as well as a natural complex agent based on Bacillus spp. Patients in the reference group (n = 30), in addition to basic therapy, took resveratrol and vitamin D without a probiotic complex. Before the start of treatment, after 1 and 3 months, patients made an immunogram and were monitored for clinical symptoms of CFS. Results. In the study group, various symptoms of CFS disappeared earlier, and their number was relatively smaller after the end of therapy. In particular, it should be noted that a significantly higher proportion of patients did not have the main clinical manifestation of CFS after 3 months — 73.3 %. Also, according to the results of this work, the study group reported a more pronounced regression of the main clinical manifestations of CFS, which are associated with a secondary immunodeficiency state: subfebrile temperature, pharyngitis and lymphadenopathy. The data obtained indicate that in the study group at the third control point, the indicators of T-helper cells (CD4) and T-cytotoxic lymphocytes (CD8) significantly increased — by 55.4 and 51.8 %, respectively, which led to an inevitable increase in the immunoregulatory index. The most significant change in the selected indicators of the immune status in the study group was an increase in the concentration of immunoglobulins G (by 68.5 %) and A (by 43.8 %) compared to baseline; the results obtained, in turn, were 46.5 and 28.8 % higher than those in the control group, p < 0.05. Conclusions. The use of a Bacillus-based probiotic as an additional tool in the management of patients with OS of AD and ACD accompanied by chronic fatigue syndrome led to a more complete restoration of cellular and humoral immunity than in the control group. Also, in the study group, a more pronounced regression of clinical symptoms of CFS was observed, in particular, the symptom complex associated with the immunodeficiency state. Given the results of this research, it is reasonable to recommend the integration of a probiotic component into the comprehensive therapy for OS of AD and ACD accompanied by chronic fatigue.